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Ji N, Kumar A, Joe W, Kuriyan R, Sethi V, Finkelstein JL, Mehta S. Prevalence and Correlates of Double and Triple Burden of Malnutrition Among Children and Adolescents in India: A Comprehensive National Nutrition Survey. J Nutr 2024:S0022-3166(24)00472-3. [PMID: 39209112 DOI: 10.1016/j.tjnut.2024.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/23/2024] [Accepted: 08/24/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Limited information on the co-prevalence of undernutrition, micronutrient deficiencies, overnutrition, and abnormal levels of noncommunicable disease biomarkers at the same time in children and adolescents in India hinders efforts to comprehensively address their health. OBJECTIVES This study aimed to examine the prevalence and correlates of double burden of malnutrition (DBM) and triple burden of malnutrition (TBM) among children and adolescents (5-19 y) to inform policies and programs. METHODS A total of 17,599 children (5-9 y) and 16,184 adolescents (10-19 y) with available biomarker data from the Comprehensive National Nutrition Survey were included. Malnutrition was defined based on either undernutrition based on anthropometry, overnutrition/abnormal metabolic markers, and anemia/micronutrient deficiency. DBM was defined as the coexistence of any 2 forms of malnutrition. DBM+ was defined as the coexistence of undernutrition and/or micronutrient deficiency along with overnutrition. TBM was defined as having the coexistence of all 3 forms of malnutrition. The prevalence of DBM, DBM+, and TBM was estimated accounting for probabilistic selection. We used mixed-effect binomial regression to determine correlates of DBM/TBM in children and adolescents separately. RESULTS The prevalence of DBM, DBM+, and TBM was 50.8%, 37.2%, and 14.4%, respectively, in children and 53.4%, 36.1%, and 12.7%, respectively, in adolescents. The prevalence of DBM+ was significantly higher in children girls than that in boys. In children, being in a disadvantaged caste group, having a lower wealth index, having inadequate diet diversity, having no maternal schooling, and having a recent history of acute illness were associated with DBM. In adolescents, being in a disadvantaged caste group, maternal occupation, and lower paternal age were correlated with DBM. A similar set of variables was associated with TBM in both age groups. CONCLUSIONS The prevalence of DBM and TBM is substantial in children and adolescents in India and varies across states. Socioeconomic factors and acute illness were the main correlates for DBM and TBM.
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Affiliation(s)
- Naiwen Ji
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Abhishek Kumar
- Population Research Centre, Institute of Economic Growth, Delhi University North Campus, Delhi, India
| | - William Joe
- Population Research Centre, Institute of Economic Growth, Delhi University North Campus, Delhi, India
| | - Rebecca Kuriyan
- Division of Nutrition, St. John's Research Institute, Bengaluru, Karnataka, India
| | - Vani Sethi
- UNICEF Regional Office for South Asia, Kathmandu, Bāgmatī, Nepal
| | - Julia L Finkelstein
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States; Division of Nutrition, St. John's Research Institute, Bengaluru, Karnataka, India; Center for Precision Nutrition and Health, Cornell Human Ecology, Cornell University, Ithaca, NY, United States
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States; Center for Precision Nutrition and Health, Cornell Human Ecology, Cornell University, Ithaca, NY, United States; Division of Medical Informatics, St. John's Research Institute, Bengaluru, Karnataka, India.
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Melaku EE, Urgie BM, Tilahun AT, Assefa HK, Abebe AA, Tefera AS. Prevalence of vitamin B 12 deficiency and associated factors among primary school children: North East Ethiopia: multicenter cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:82. [PMID: 38867328 PMCID: PMC11170803 DOI: 10.1186/s41043-024-00568-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/11/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND The prevalence of Vitamin B12 deficiency is common and is more frequent in low- and middle-income countries with a poor or inadequate diet of animal foods. In Ethiopia, researches related to the status of micronutrients in children are limited. Therefore, this study aimed to assess the prevalence of vitamin B12 deficiency and associated factors among primary school children. METHODS A cross-sectional study design was conducted from January 10-February 30/2023. A total of 514 students were selected using a systematic random sampling technique. Face-to-face interviews using a structured questionnaire, document review, anthropometric measurement, and laboratory studies were implemented to collect data. Data was analyzed by STATA version 14 and summarized by using frequency tables and graphs. Logistic regression analysis was done to identify factors associated with vitamin B12 Deficiency. RESULTS About 34% of the students were found to have vitamin B12 deficiency. Not Consuming animal products (AOR = 1.83, 95% CI:1.20-2.79) and low body mass index (AOR = 1.62, 95% CI:1.05-2.47) were associated with vitamin B12 deficiency. CONCLUSIONS The study revealed a notable high deficiency of vitamin B12 in primary school students. Consumption of animal products and BMI were identified as statically significant associated factors with serum concentration of vitamin B12.
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Affiliation(s)
| | | | | | | | | | - Aklile Semu Tefera
- Department of Epidemiology, Debre Berhan University, Debre Berhan, Ethiopia
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Ganie MA, Bashir R, Sehar T, Asrar M, Khan S, Baba S, Tandon N, Dhadwal V, Jyotsna V, Dwivedi SN. Impact of Prevalent Dietary Pattern on Serum Vitamin B12 Status and Its Association With Inflammation Among Reproductive Age Women. Mol Nutr Food Res 2024; 68:e2300315. [PMID: 38766917 DOI: 10.1002/mnfr.202300315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 04/15/2024] [Indexed: 05/22/2024]
Abstract
SCOPE Association between vitamin B12 deficiency (VB12D) and dietary patterns being well documented has bearing on obstetrics and neonatal outcomes. However, relationship between VB12D and serum inflammatory markers (IMs), particularly in vegetarian diet and Polycystic ovary syndrome (PCOS), remains elusive. This cross-sectional study assesses VB12D and IMs among reproductive age women consuming different diets. METHODS AND RESULTS Nonvegetarian (PCOS, n = 104; healthy, n = 148) and vegetarian women (PCOS n = 112; healthy, n = 186) are for evaluated clinical, biochemical, hormonal assessment, inflammatory, and four vitamin B 12 (VB12) markers. VB12D is defined by Fedosov's wellness quotient (4cB12). Using 4cB12, prevalence of VB12D is discerned in 54.4% (PCOS: 72.1%; healthy 36.5%) and 93.4% (PCOS: 95.9%; healthy: 91.9%) among nonvegetarians and vegetarians, respectively. Vegetarian PCOS women depict lowest median (interquartile range [IQR]) of serum B12 76.2(72.6) pg mL-1, holotranscobalamine (HTC) 37.9(11.3) and highest homocysteine (HCY) 40.32(6.0) µmol L-1, methylmalonic acid (MMA) 352.26(156.7) nmol L-1 with highest Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and IMs (Monocyte chemoattractant protein 1 (MCP-1), High sensitivity C-reactive protein (hs-CRP), Tumour Necrosis Factor alpha (TNF-α) and Interleukin 6 (IL-6)). Significant correlation of serum hs-CRP, TNF-α, and IL-6 with VB12 markers is observed. CONCLUSION The VB12D is rampant among reproductive age women that gets exacerbated by PCOS or vegetarian diet. It is directly correlated with magnitude of proinflammatory markers. The results carry substantial implications for public health policies aimed at improving preconception maternal VB12 status for better future pregnancy and offspring outcomes.
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Affiliation(s)
| | - Rohina Bashir
- Departments of Endocrinology, Srinagar, India
- Clinical Research, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Tajali Sehar
- Departments of Endocrinology, Srinagar, India
- Clinical Research, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Mir Asrar
- Clinical Research, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Shahid Khan
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Saleem Baba
- Departments of Endocrinology, Srinagar, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Vatsla Dhadwal
- Department of Obstetricians and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Vivekap Jyotsna
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Demirtas MS, Kilicaslan C, Erdal H. Evaluation of vitamin B12 levels among severe obese and obese adolescents. J Investig Med 2024; 72:319-325. [PMID: 38148386 DOI: 10.1177/10815589231225180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Obesity, whose prevalence is increasing globally, is malnutrition that causes micro/macronutrients and vitamin deficiencies in adolescents. Vitamin B12 plays a prominent role in the body systems such as remethylation, deoxidation, and DNA synthesis. We aimed to examine the relationship between severe obese/obese adolescents and vitamin B12 levels in this study. This study was conducted as a case-control study consisting of 44 obese and 40 healthy control adolescents aged 11-17 years. Obesity was diagnosed using body mass index (BMI) charts defined by the World Health Organization according to age and gender. Vitamin B12 deficiency was found to be 34.1% in the patient obesity group, while it was 12.5% in the control group (p = 0.02). Homeostatic Model Assessment for Insulin Resistance levels were found to be 3.09 (1.9-5.29) higher in the severely obese group (p < 0.001). The median level of vitamin B12 in the obese group was 173 (122.5-220.7) in the severe obese group, 197 (146.5-302.7) in the obese group, and 252.5 (192.8-302) in the control group (p = 0.021). We found that obesity has a 1.6-fold decreasing effect on vitamin B12 levels. This study shows the clinician the importance of monitoring BMI and vitamin B12 levels in obese adolescents, given the effects of vitamin B12 on neuronal migration, metabolic reactions, and many systems in the body. Further researches are needed to investigate the pathophysiology and effect of low vitamin B12 levels in obese adolescents.
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Affiliation(s)
| | - Cengizhan Kilicaslan
- Department of Pediatrics, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Huseyin Erdal
- Department of Medical Genetics, Faculty of Medicine, Aksaray University, Aksaray, Turkey
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Choedon T, Brennan E, Joe W, Lelijveld N, Huse O, Zorbas C, Backholer K, Murira Z, Wrottesley SV, Sethi V. Nutritional status of school-age children (5-19 years) in South Asia: A scoping review. MATERNAL & CHILD NUTRITION 2024; 20:e13607. [PMID: 38095279 PMCID: PMC10981491 DOI: 10.1111/mcn.13607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 04/01/2024]
Abstract
Information on malnutrition for school-age children and adolescents (5-19 years) in South Asia is fragmented and inconsistent, which limits the prioritization of nutrition policies, programmes and research for this age group. This scoping review aimed to synthesize existing evidence on the burden of malnutrition for children and adolescents aged 5-19 years in South Asia, and on interventions to improve their nutritional status. Cochrane Library, EMBASE, Medline and Google Scholar were systematically searched for articles published between January 2016 and November 2022. Eligible studies reported the prevalence of undernutrition, overweight/obesity, micronutrient deficiencies and unhealthy dietary intakes, and interventions that aimed to address these in South Asia. In total, 296 articles met our inclusion criteria. Evidence revealed widespread, yet heterogeneous, prevalence of undernutrition among South Asian children and adolescents: thinness (1.9%-88.8%), wasting (3%-48%), underweight (9.5%-84.4%) and stunting (3.7%-71.7%). A triple burden of malnutrition was evident: the prevalence of overweight and obesity ranged from 0.2% to 73% and 0% to 38% (with rapidly rising trends), respectively, alongside persistent micronutrient deficiencies. Diets often failed to meet nutritional requirements and high levels of fast-food consumption were reported. Education, fortification, supplementation and school feeding programmes demonstrated beneficial effects on nutritional status. Comprehensive and regular monitoring of all forms of malnutrition among children and adolescents, across all countries in South Asia is required. Further, more large-scale intervention research is needed to ensure policy and programmes effectively target and address malnutrition among children and adolescents in South Asia.
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Affiliation(s)
| | | | - William Joe
- Institute of Economic Growth (IEG)DelhiIndia
| | | | - Oliver Huse
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
| | | | | | - Vani Sethi
- UNICEF South Asia Regional OfficeKathmanduNepal
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Mercantepe F. Relationship of Vitamin B12 Levels With Different Degrees of Obesity and Diabetes Mellitus. Cureus 2023; 15:e47352. [PMID: 38021783 PMCID: PMC10657338 DOI: 10.7759/cureus.47352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION The potential influence of micronutrient status on obesity should be considered. Nevertheless, previous research examining the relationship between serum vitamin B12 levels and obesity has yielded inconclusive results. The objective of this study was to investigate the associations between serum vitamin B12 levels and obesity and diabetes mellitus (DM) in a population consisting of persons aged 18 years and older. METHODS A retrospective case-control research was undertaken on a sample of 1024 individuals aged 18 years and older who were admitted to a tertiary healthcare facility (Recep Tayyip Erdoğan University Education and Research Hospital, Rize) for either overweight-related issues or routine check-ups. The primary objective of this study was to assess the B12 levels of these individuals. The researcher recorded the body mass index (BMI) and history of DM for all subjects. RESULTS The study comprised a total of 1024 participants, consisting of 834 females and 190 males. The levels of vitamin B12 in women were found to be 308±113 pg/mL, while in men, the levels were 304±125 pg/mL. The results of the statistical analysis indicate that there is no statistically significant disparity in vitamin B12 levels between males and females (p=0.748). There was a statistically significant positive correlation seen between age and B12 levels; however, the magnitude of this connection was found to be minor (p=0.000, R2=0.017). The study findings revealed that out of the 1,024 individuals evaluated, 179 individuals exhibited B12 levels below 200, while 845 individuals displayed vitamin B12 levels above 200. The study findings indicated that there was no statistically significant distinction observed in the occurrence of obesity and DM in relation to vitamin B12 deficiency (p = 0.938, p = 0.08, respectively). CONCLUSION The results of this study offer empirical support for the notion that there is no significant difference in vitamin B12 levels between individuals afflicted with obesity and diabetes and those unaffected by these conditions. Interestingly, it was shown that serum B12 levels exhibited a modest increase with advancing age.
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Affiliation(s)
- Filiz Mercantepe
- Endocrinology, Diabetes and Metabolism, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, TUR
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7
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Kumar KJ, Balaji S, Kulkarni P, Manjunath VG, Nandish HR. Vitamin B12 Status in Rural Adolescent School Girls in Mysuru, India: A Community-Based Cross-Sectional Study. Indian J Community Med 2023; 48:794-797. [PMID: 37970155 PMCID: PMC10637595 DOI: 10.4103/ijcm.ijcm_863_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 07/01/2023] [Indexed: 11/17/2023] Open
Abstract
Almost 56% of Indian adolescent girls aged 15-19 years suffer from anemia. Adolescent age is a period of many significant physiological changes that increase nutritional demand, and they remain at risk for nutritional deficiencies. Our aim is to assess the prevalence of Vitamin B12 deficiency among school-going adolescent girls aged 13-16 years of rural Mysore. This study was a cross-sectional study, conducted in two high schools in rural Mysuru. Adolescent girls aged 13-16 years were included. The chosen subjects underwent complete hemogram, peripheral smear examination, and vitamin B12 level estimation. Out of 98 subjects enrolled, 40.81% were found to be deficient in vitamin B12. Macrocytes and hyper-segmented neutrophils were found to have statistically significant (P value < 0.001) relationship with vitamin B12 deficiency. The relationship between vitamin B12 deficiency with either type of diet and anemia was statically insignificant (P > 0.05). The prevalence of vitamin B12 deficiency among rural adolescent girls in Mysuru is high. Other causes of nutritional anemia apart from iron deficiency, such as vitamin B12 deficiency, must be considered in the etiology of anemia and optimally treated. It is recommended to further strengthen the adolescent national health programs and food fortification programs.
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Affiliation(s)
- K. Jagadish Kumar
- Pediatrics, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Sangeetha Balaji
- Pediatrics, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Praveen Kulkarni
- Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - V G Manjunath
- Pediatrics, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - H R Nandish
- Pediatrics, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Shalini T, Pullakhandam R, Ghosh S, Kulkarni B, Rajkumar H, Sachdev HS, Kurpad AV, Reddy GB. Prevalence of Vitamin B 12 and Folate Deficiencies in Indian Children and Adolescents. Nutrients 2023; 15:3026. [PMID: 37447351 DOI: 10.3390/nu15133026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Deficiencies of vitamin B12 (B12) and folate (FA) are of particular interest due to their pleiotropic role in 1-carbon metabolism. In addition to adverse birth outcomes, deficiencies of B12 and FA, or an imbalance in FA/B12 status, are linked to metabolic disorders. Indian diets that are predominantly plant food-based could be deficient in these vitamins, but there are no national estimates of the prevalence of B12 and FA deficiency in Indian children and adolescents, nor their associations with age, sex and growth indicators. The recent Comprehensive National Nutrition Survey (CNNS-2016-18) provided estimates of the prevalence of B12 and FA deficiency at the national and state levels among preschool (1-4 years: 9976 and 11,004 children, respectively), school-age children (5-9 years: 12,156 and 14,125) and adolescents (10-19 years: 11,748 and 13,621). Serum B12 and erythrocyte FA were measured by the direct chemiluminescence method and their deficiency was defined using WHO cut-offs. The prevalence of B12 and FA deficiency was high among adolescents (31.0%, CI: 28.7-33.5 and 35.6%, CI: 33.1-8.2) compared to school-age (17.3%, CI: 15.4-19.3 and 27.6%, CI: 25.5-29.9) and preschool children (13.8%, CI: 11.7-16.2 and 22.8%, CI: 20.5-25.2, respectively). The prevalence of both B12 and FA deficiency was significantly higher by 8% and 5%, respectively, in adolescent boys compared to girls. There was no association between anthropometric undernutrition and B12 and FA deficiency. There was wide regional variation in the prevalence of B12 and FA deficiency, but no rural-urban differences were observed across all age groups. The national prevalence of B12 deficiency among preschool or school-age children was <20% (the cut-off that indicates a public health problem). However, FA deficiency in these age groups and both FA and B12 deficiencies in adolescents were >20%, warranting further investigation.
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Affiliation(s)
- Tattari Shalini
- National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad 500007, India
| | - Raghu Pullakhandam
- National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad 500007, India
| | - Santu Ghosh
- St. John's Medical College, Bangalore 560034, India
| | - Bharati Kulkarni
- National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad 500007, India
| | - Hemalatha Rajkumar
- National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad 500007, India
| | - Harshpal S Sachdev
- Sitaram Bhartia Institute of Science and Research, New Delhi 110016, India
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Shirode PS, Parekh AD, Patel VV, Vala J, Jaimalani AM, Vora NM, Gummalla V, Patel JS, Shriram N. Early Detection of Subclinical Atherosclerosis: Hyperhomocysteinemia as a Promising Marker in Adolescents With Vitamin B Deficiency. Cureus 2023; 15:e41571. [PMID: 37554588 PMCID: PMC10406394 DOI: 10.7759/cureus.41571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2023] [Indexed: 08/10/2023] Open
Abstract
In recent decades, the increased incidence of cardiovascular disease (CVD) mortality among young adults has raised concerns. Although clinical manifestations of CVD typically occur later in life, the underlying pathological processes emerge early on. This review article summarizes the association between vitamin B deficiency-induced hyperhomocysteinemia and subclinical atherosclerosis in adolescents. Numerous studies have demonstrated that elevated homocysteine levels are an independent risk factor for endothelial dysfunction (ED) and arterial stiffness, which are key contributors to CVD. Notably, vitamin B deficiency, particularly in vitamin B9 and vitamin B12, emerges as a significant factor in childhood hyperhomocysteinemia, initiating the development of subclinical atherosclerosis in early life. A comprehensive review of relevant literature from prominent bibliographic databases, including PubMed/MEDLINE, PubMed Central, Google Scholar, and Cochrane, was performed. Four cross-sectional studies focusing on homocysteine levels as an exposure variable and markers of atherosclerosis as outcome measures were included and reviewed as part of our analysis. The reviewed studies demonstrate a positive correlation between homocysteine levels and markers of atherosclerosis, including increased carotid intima-media thickness (CIMT) and ED. Mainly, adolescents with vitamin B12 deficiency exhibit a significant positive correlation between homocysteine levels and CIMT. These findings underscore the potential of hyperhomocysteinemia as an early marker for detecting subclinical atherosclerosis in adolescents with vitamin B deficiency. Despite limited research in this area, recognizing the importance of early detection and management of subclinical atherosclerosis in adolescents can help mitigate the risk of severe cardiovascular events such as myocardial infarction and stroke in young adulthood.
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Affiliation(s)
- Parth S Shirode
- Pediatrics, Terna Speciality Hospital & Research Centre, Navi Mumbai, IND
| | - Anjali D Parekh
- Pediatrics, Surat Municipal Institute of Medical Education and Research, Surat, IND
| | - Vishwa V Patel
- Internal Medicine, Pramukhswami Medical College, Anand, IND
| | - Janmay Vala
- Internal Medicine, Terna Speciality Hospital & Research Centre, Navi Mumbai, IND
| | - Aniket M Jaimalani
- Internal Medicine, Surat Municipal Institute of Medical Education and Research, Surat, IND
| | - Nilofar M Vora
- Pediatrics, Terna Speciality Hospital & Research Centre, Navi Mumbai, IND
| | - Vaishnavi Gummalla
- Internal Medicine, Gandhi Institute of Technology and Management (GITAM) Institute of Medical Sciences and Research, Visakhapatnam, IND
| | | | - Nikitha Shriram
- Internal Medicine, Terna Speciality Hospital & Research Centre, Navi Mumbai, IND
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Venkata Surekha M, Shravanthi G, Shalini T, Uday Kumar P. Vitamin B12 status in term pregnant women and the cord blood samples of their newborns: A cross-sectional study. Nutr Health 2023:2601060231151720. [PMID: 36803291 DOI: 10.1177/02601060231151720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Background and aim: In India, total vitamin B12 (Vit B12) and its active form (active B12) have not been studied in mother's blood and cord blood. We hypothesized that total and active B12 levels are sufficiently maintained in cord blood despite low levels in mothers. Methods: Two hundred term pregnant mother's blood and cord blood was collected and analyzed for total Vit B12 (radioimmunoassay method) and active B12 levels (enzyme-linked immunosorbent assay). Mean values of constant or continuous variables (hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), white blood cells (WBC), and Vit B12) were compared in mother's blood and newborn cord blood using Student's t-test and multiple comparisons within the groups were carried out with ANOVA. Spearman's correlation (Vit B12) and multivariable backward regression analyses (height, weight, education, body mass index (BMI) and Hb, PCV, MCV, WBC, and Vit B12 levels) were also performed. Results: Total Vit 12 deficiency was highly prevalent at 89% and active B12 deficiency was 36.7% in mothers. Cord blood showed total Vit B12 deficiency prevalence of 53% and active B12 deficiency being 9.3%. Total Vit B12 (p<0.001) and active B12 (p<0.001) levels were significantly higher in cord blood when compared to mother's blood. In multivariate analysis, higher total and active B12 levels in mother's blood predicted higher levels of total and active B12 levels in cord blood. Conclusion: Our study showed higher prevalence of total and active Vit B12 deficiency in mothers compared to cord blood thus indicating their transfer to fetus irrespective of mother's status. Maternal Vit B12 levels affected cord blood Vit B12 levels.
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Affiliation(s)
- Mullapudi Venkata Surekha
- Pathology and Microbiology Division, Indian Council of Medical Research (ICMR) - National Institute of Nutrition, Hyderabad, India
| | | | - Tattari Shalini
- Biochemistry Division, 28603ICMR - National Institute of Nutrition, Hyderabad, India
| | - Putcha Uday Kumar
- Pathology and Microbiology Division, Indian Council of Medical Research (ICMR) - National Institute of Nutrition, Hyderabad, India
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Dhillon P, Sahoo H, Usman M, Srivastava A, Agrawal PK, Johnston R, Unisa S. Status and correlates of micronutrient deficiencies in slum and non-slum areas of India's four metropolitan cities: Investigation from CNNS. Soc Sci Med 2022; 309:115259. [DOI: 10.1016/j.socscimed.2022.115259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/24/2022] [Accepted: 08/01/2022] [Indexed: 10/15/2022]
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12
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Awasthi S, Kumar D, Mahdi AA, Agarwal GG, Pandey AK, Parveen H, Singh S, Awasthi R, Pande H, T. S. A, Mahanta BN, Singh CM, Mathew JL, Ahmad MK, Singh K, Bhat MA, A. R. S, Kar S, Nair S. Prevalence of specific micronutrient deficiencies in urban school going children and adolescence of India: A multicenter cross-sectional study. PLoS One 2022; 17:e0267003. [PMID: 35544476 PMCID: PMC9094555 DOI: 10.1371/journal.pone.0267003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/01/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Childhood and adolescence require adequate amount of micronutrients for normal growth and development. The primary objective of study was to assess the prevalence of deficiencies of Vitamins (Vitamin A, 25 Hydroxy Vitamin D, Vitamin B12 and Folate) and minerals (Calcium, Zinc, Selenium and Iron), among urban school going children aged 6–11 and 12–16 years in ten cities of India. Secondary objective was to find the association between micronutrient deficiencies with sociodemographic and anthropometric indicators. Methods A multi-center cross-sectional study was conducted across India. Participants in the age groups of 6 to 11 years (group 1) and 12 to 16 years (group 2) were selected from randomly chosen schools from each center. Data on socio economic status, anthropometric measures was collected. Blood samples were collected for biochemical analysis of micronutrients. Point estimates and 95% confidence intervals was used to assess the prevalence of deficiencies. Associations were observed using chi square, student t test and ANOVA test. Results From April 2019 to February 2020, 2428 participants (1235 in group 1 and 1193 group 2) were recruited from 60 schools across ten cites. The prevalence of calcium and iron deficiency was 59.9% and 49.4% respectively. 25 Hydroxy Vitamin D deficiency was seen in 39.7% and vitamin B12 in 33.4% of subjects. Folate, Selenium and Zinc were deficient in 22.2%, 10.4% and 6.8% of subjects respectively. Vitamin A deficiency least (1.6%). Anemia was prevalent in 17.6% subjects and was more common among females. Conclusion One or more micronutrient deficiencies are found in almost one half of school going children in urban area. Hence efforts must be made to combat these on priority. Trial registration number CTRI/2019/02/017783.
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Affiliation(s)
- Shally Awasthi
- Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
- * E-mail:
| | - Divas Kumar
- Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Abbas Ali Mahdi
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Girdhar G. Agarwal
- Department of Statistics, University of Lucknow, Lucknow, Uttar Pradesh, India
| | - Anuj Kumar Pandey
- Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Hina Parveen
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Shweta Singh
- Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Rajiv Awasthi
- Prarthana Diabetic Care Centre, Lucknow, Uttar Pradesh, India
| | - Harsh Pande
- Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Anish T. S.
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerela, India
| | - B. N. Mahanta
- Department of Medicine, Assam Medical College, Dibrugarh, Assam, India
| | - C. M. Singh
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Joseph L. Mathew
- Department of Pediatric Medicine, Post Graduate Institute of Medical Sciences, Chandigarh, India
| | - Mohammad Kaleem Ahmad
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mushtaq A. Bhat
- Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Somashekar A. R.
- Department of Pediatrics, M. S. Ramaiah Institute of Medical Sciences, Bangalore, Karnataka, India
| | - Sonali Kar
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - Suma Nair
- Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, India
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Is There An Association Between Vitamin B12 Level and Vitamin D Status in Children? J Pediatr Hematol Oncol 2022; 44:e677-e681. [PMID: 35319507 DOI: 10.1097/mph.0000000000002329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/16/2021] [Indexed: 11/26/2022]
Abstract
Vitamin B12 (vit B12) or cobalamin is a water-soluble vitamin that acts as a coenzyme and is effective in the formation of a healthy nervous system and erythrocytes. In its deficiency, except fatigue and weakness, may cause serious signs and symptoms such as macrocytic anemia, cognitive-developmental delay, irreversible neurological damage. In this study, hemoglobin, leukocyte, thrombocyte, iron, iron-binding, ferritin, and vit B12 levels were evaluated retrospectively during the routine controls of 689 children 5 to 18 years old without any complaints. In addition, the relationship between serum 25-Hydroxyvitamin D (vit D) levels and vit B12 levels, which were evaluated in 487 of the cases, was investigated. Vit B12 deficiency was diagnosed in a total of 160 (23.2%) cases, 99 (24.4%) girls and 61 (21.4%) boys. Vit B12 level was significantly lower in children over 12 years old. Vitamin D deficiency was found to be 49.3% in 487 cases and was significantly higher in the group under 12 years and girls. The frequency of anemia was 7.2% in this group. There was a significant relationship between vit D deficiency and vit B12 deficiency. In conclusion, vit B12 deficiency is common in school-age children, especially in the adolescent age group. It should be known that vit D deficiency may also be present in vit B12 deficiency cases. More comprehensive studies are needed to reveal the relationship between B12 and vit D deficiency.
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14
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Gupta S, Haldar P, Singh A, Malhotra S, Kant S. Prevalence of serum cobalamin and folate deficiency among children aged 6–59 months: A hospital-based cross-sectional study from Northern India. J Family Med Prim Care 2022; 11:1063-1069. [PMID: 35495818 PMCID: PMC9051736 DOI: 10.4103/jfmpc.jfmpc_1137_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/14/2021] [Accepted: 10/23/2021] [Indexed: 11/04/2022] Open
Abstract
Context: Cobalamin and folate are essential for the synthesis of nucleic acids and in the maintenance of myelin. They are required during the period of the rapid growth of infancy and childhood. Their deficiency may result in nutritional anemia and neurological manifestations. There is paucity of literature regarding the prevalence of cobalamin and folate deficiency among North Indian children aged 6–59 months. Aim: The aim of this study was to estimate the prevalence of serum cobalamin and folate deficiency among children aged 6–59 months, attending a secondary care hospital. Settings and Design: Children were recruited from pediatrics OPD of the sub-district hospital (SDH), Ballabgarh, Haryana, through systematic random sampling. Hemoglobin was measured by an automated analyzer. Serum cobalamin and serum folate were estimated using enhanced chemiluminescence based immunoassay. Results: A total of 420 children were recruited, of which 392 provided a blood specimen. Prevalence of cobalamin, folate deficiency, and anemia were 22.3% (95% CI: 18.3–26.7), 10.9% (95% CI: 8.2–14.6), and 81.9% (95% CI 77.7–85.4), respectively. The proportion of children with cobalamin deficiency who had anemia was 97.7% compared to 95.7% among those with no cobalamin deficiency (P = 0.396). Similarly, the proportion of children with folate deficiency who had anemia was 95.2% compared to 96.2% among those with no folate deficiency (P = 0.765). Conclusion: We found that almost one in five children aged 6–59 were deficient in cobalamin, and one in ten were deficient in folate.
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Obeid R, Eussen SJPM, Mommers M, Smits L, Thijs C. Imbalanced Folate and Vitamin B12 in the Third Trimester of Pregnancy and its Association with Birthweight and Child Growth up to 2 Years. Mol Nutr Food Res 2021; 66:e2100662. [PMID: 34821015 DOI: 10.1002/mnfr.202100662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/12/2021] [Indexed: 01/25/2023]
Abstract
SCOPE Folic acid supplementation during pregnancy may lead to an imbalance when vitamin B12 intake is low (folate trap) and may affect child's growth. METHODS The authors study the association between third trimester maternal intakes of folate and B12 and birthweight and postnatal growth of 2632 infants from the KOALA Birth Cohort Study. Plasma vitamin biomarkers are measured in 1219 women. RESULTS Imbalanced total intakes (folate > 430 µg day-1 combined with B12 < 5.5 µg day-1 ) are not associated with birthweight [β adj (95% CI) = -14.87 (-68.87, 39.13)] compared with high intakes of both. Imbalanced intake is associated with a lower z score of weight at 1-2 years [β adj = -0.14 (-0.25, -0.03)]. Having red blood cell folate > 745 nmol L-1 and plasma B12 < 172 pmol L-1 is not associated with birthweight [β adj = -7.10 (-97.90, 83.71) g]. Maternal dietary B12 intake [β adj = -9.5 (-15.6, -3.3)] and plasma methylmalonic acid [β adj = 234 (43, 426)] are associated with birthweight. CONCLUSION Low maternal dietary B12 intake and elevated methylmalonic acid rather than imbalanced vitamins are associated with higher birthweight, suggesting that low maternal B12 can predispose the infants for later obesity.
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Affiliation(s)
- Rima Obeid
- Department of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, Kirrberg street, Building 57, Homburg, Saarland, D-66421, Germany
| | - Simone J P M Eussen
- Department of Epidemiology, Maastricht University Medical Centre+, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Monique Mommers
- Department of Epidemiology, Maastricht University Medical Centre+, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
| | - Luc Smits
- Department of Epidemiology, Maastricht University Medical Centre+, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
| | - Carel Thijs
- Department of Epidemiology, Maastricht University Medical Centre+, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
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16
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Akyay A, Soylu E, Ünsal S, Demirol H, Bahçeci S. Hearing status in vitamin B12-deficient children. J Paediatr Child Health 2021; 57:1060-1066. [PMID: 33600619 DOI: 10.1111/jpc.15392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 01/08/2021] [Accepted: 01/29/2021] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study is to investigate the effects of vitamin B12 deficiency on hearing in school-aged children by pure-tone audiometry. METHODS Forty-three vitamin B12-deficient children and 37 age-matched control subjects were enrolled in the study. Tympanometric evaluations and pure-tone audiometry including high frequencies were performed on the subjects. The results were compared between the two groups. RESULTS Both right and left ear pure-tone hearing thresholds (PTHTs) at 0.25-4 kHz, and four-frequency pure-tone average values were significantly better in the control group compared with the patient group (P < 0.05). However, PTHTs at 8-16 kHz were not different between the two groups (P > 0.05). Vitamin B12 level also did not show any significant correlation with the PTHTs at 0.25-16 kHz (P > 0.05). CONCLUSION This study indicates that vitamin B12 deficiency may contribute to hearing impairment at low frequencies as a possible aetiological factor in children.
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Affiliation(s)
- Arzu Akyay
- Faculty of Medicine, Department of Pediatric Hematology and Oncology, Inonu University, Malatya, Turkey
| | - Erkan Soylu
- Faculty of Medicine, Department of Otorhinolaryngology, Medipol University, İstanbul, Turkey
| | - Selim Ünsal
- Faculty of Health Science, Department of Language and Speech Therapy, İstinye University, İstanbul, Turkey
| | - Hatice Demirol
- Faculty of Medicine, Department of Pediatric Gastroenterology and Hepatology, Fırat University, Elazığ, Turkey
| | - Semiha Bahçeci
- Department of Pediatric Allergy and Immunologyy, Çiğli Training and Research Hospital, İzmir, Turkey
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17
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Shekhar R, Srinivasan VK, Pai S. How I investigate dysgranulopoiesis. Int J Lab Hematol 2021; 43:538-546. [PMID: 34031992 DOI: 10.1111/ijlh.13607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/23/2021] [Accepted: 04/30/2021] [Indexed: 12/23/2022]
Abstract
Dysgranulopoiesis is a condition in which granulocytic production is defective and is most often described in neoplastic conditions. However, it can also be frequently seen in non-neoplastic conditions. Early suspicion and detection of these non-neoplastic causes may prevent further invasive and expensive interventions. In this review, we take a look at the various causes of dysgranulopoiesis with an emphasis on non-neoplastic etiologies, followed by a detailed outline of the laboratory approach for determining its many causes.
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Affiliation(s)
- Roshini Shekhar
- Department of Laboratory Medicine, Manipal Hospital, Bengaluru, Karnataka, India
| | - Vishrut K Srinivasan
- Department of Laboratory Medicine, Manipal Hospital, Bengaluru, Karnataka, India
| | - Swati Pai
- Department of Laboratory Medicine, Manipal Hospital, Bengaluru, Karnataka, India
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18
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Finkelstein JL, Fothergill A, Johnson CB, Guetterman HM, Bose B, Jabbar S, Zhang M, Pfeiffer CM, Qi YP, Rose CE, Williams JL, Bonam W, Crider KS. Anemia and Vitamin B-12 and Folate Status in Women of Reproductive Age in Southern India: Estimating Population-Based Risk of Neural Tube Defects. Curr Dev Nutr 2021; 5:nzab069. [PMID: 34027296 PMCID: PMC8128722 DOI: 10.1093/cdn/nzab069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Women of reproductive age (WRA) are a high-risk population for anemia and micronutrient deficiencies. However, there are few representative population-level data from India, which could help inform evidence-based recommendations and policy. OBJECTIVE To conduct a population-based biomarker survey of anemia and vitamin B-12 and folate status in WRA as part of a periconceptional surveillance program in southern India. METHODS Participants were WRA (15-40 y) who were not pregnant or lactating. Whole blood (n = 979) was analyzed for hemoglobin via a Coulter counter (Coulter HMX). Plasma, serum, and RBCs were processed and stored at -80°C or less until batch analysis. Vitamin B-12 concentrations were measured via chemiluminescence; RBC and serum folate concentrations were evaluated via microbiological assay. Anemia and severe anemia were defined as hemoglobin <12.0 g/dL and <8.0 g/dL, respectively. Vitamin B-12 deficiency and insufficiency were defined as total vitamin B-12 <148 pmol/L and <221 pmol/L, respectively. Folate deficiency and insufficiency were defined as RBC folate <305 nmol/L and <748 nmol/L. A previously developed Bayesian model was used to predict neural tube defect (NTD) prevalence per 10,000 births. RESULTS A total of 41.5% of WRA had anemia and 3.0% had severe anemia. A total of 48.3% of WRA had vitamin B-12 deficiency and 74.3% had vitamin B-12 insufficiency. The prevalence of RBC folate deficiency was 7.6%, and 79.3% of WRA had RBC folate <748 nmol/L, the threshold for optimal NTD prevention. Predicted NTD prevalence per 10,000 births based on RBC folate concentrations was 20.6 (95% uncertainty interval: 16.5-25.5). CONCLUSIONS The substantial burden of anemia, vitamin B-12 deficiency, and RBC folate insufficiency in WRA in this setting suggests an opportunity for anemia and birth defects prevention. Findings will directly inform the development of a randomized trial for anemia and birth defects prevention in southern India.This study was registered at clinicaltrials.gov as NCT04048330.
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Affiliation(s)
- Julia L Finkelstein
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
- St John's Research Institute, Bangalore, Karnataka, India
| | - Amy Fothergill
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | | | | | - Beena Bose
- St John's Research Institute, Bangalore, Karnataka, India
| | - Shameem Jabbar
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mindy Zhang
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christine M Pfeiffer
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yan Ping Qi
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Charles E Rose
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer L Williams
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wesley Bonam
- Arogyavaram Medical Centre, Andhra Pradesh, India
| | - Krista S Crider
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
Undernutrition is a growing public health challenge affecting growth and development during adolescence in many low- and middle-income countries. This scoping review maps the evidence on adolescent undernutrition (stunting, thinness and micronutrient deficiencies) in South Asia and highlights gaps in knowledge. Using Arksey and O'Malley's framework and the Joanna Briggs Institute Reviewers' Manual, the search included electronic bibliographic databases (Medline (OVID), Embase, Cochrane Library, Web of Science, CINAHL, PsycInfo, and Scopus) as well as various grey literature sources published up to March 2019. In total, 131 publications met the inclusion criteria of this review. All the included evidence used quantitative data and 115 publications used a cross-sectional design. Nearly 70% (n = 86) of the included publications were conducted in India. Prevalence of undernutrition was reported based on different growth references and cut-offs. Evidence is divided into publications that included an intervention component (n = 12) and publications that did not include an intervention component (n = 116), and presented in a narrative synthesis. This scoping review provides a wide range of publications on adolescent undernutrition in South Asia and identifies future research priorities in the field.
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20
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Surendran S, Vimaleswaran KS. A nutrigenetic approach to examine the relationship between vitamin B12 status and cardio‐metabolic traits in multiple ethnic groups – findings from the GeNuIne Collaboration. NUTR BULL 2021. [DOI: 10.1111/nbu.12494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- S. Surendran
- Hugh Sinclair Unit of Human Nutrition Department of Food and Nutritional Sciences University of Reading Reading UK
- Faculty of Health and Medical Sciences School of Biosciences and MedicineUniversity of Surrey Guildford UK
| | - K. S. Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition Department of Food and Nutritional Sciences University of Reading Reading UK
- Institute for Food, Nutrition and Health (IFNH) University of Reading Reading UK
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21
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Maternal vitamin B12 deficiency and perinatal outcomes in southern India. PLoS One 2021; 16:e0248145. [PMID: 33822790 PMCID: PMC8023483 DOI: 10.1371/journal.pone.0248145] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
Background Vitamin B12 deficiency during pregnancy has been associated with adverse maternal and infant health outcomes. Few prospective studies have investigated vitamin B12 status early in pregnancy, and its links to infant vitamin B12 status, particularly in India where the burden of vitamin B12 deficiency is estimated to be the highest globally. The objective of this study was to examine the associations of maternal vitamin B12 biomarkers with neonatal vitamin B12 status. Methods Pregnant women (~12 weeks’ gestation) were enrolled in a perinatal cohort study in Bangalore, India. Total vitamin B12, methylmalonic acid (MMA), and homocysteine concentrations were evaluated in maternal samples at enrollment and in neonates at birth using cord blood. Linear and binomial regression models were used to evaluate the associations of maternal vitamin B12 biomarkers with neonatal vitamin B12 status and perinatal outcomes. Results A total of 63.2% of women had vitamin B12 deficiency (<148 pmol/L), 87.2% had vitamin B12 insufficiency (<221 pmol/L), and 47.3% had impaired vitamin B12 status (vitamin B12<148 pmol/L and MMA>0.26μmol/L) at enrollment; 40.8% of neonates had vitamin B12 deficiency, 65.6% were insufficiency, and 38.1% had impaired vitamin B12 status at birth. Higher maternal vitamin B12 concentrations at enrollment were associated with increased neonatal vitamin B12 concentrations (β(SE): 0.40 (0.05); p<0.0001) and lower risk of neonatal vitamin B12 deficiency (Risk Ratio [RR]: 0.53; 95% CI: [0.43, 0.65]; p<0.0001). Maternal vitamin B12 deficiency (RR: 1.97 [1.43, 2.71]; p<0.001), insufficiency (RR: 2.18 [1.23, 3.85]; p = 0.007), and impaired vitamin B12 status (RR: 1.49 [1.13, 1.97]; p = 0.005) predicted a two-fold increase in the risk of neonatal vitamin B12 deficiency at birth. Conclusions The prevalence of vitamin B12 deficiency was high early in pregnancy and predicted neonatal vitamin B12 status. Future research is needed to determine the role of vitamin B12 in the development of pregnancy and infant outcomes, and to inform screening and interventions to improve maternal and child health.
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22
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Enhancement of stability of vitamin B12 by co-crystallization: A convenient and palatable form of fortification. J FOOD ENG 2021. [DOI: 10.1016/j.jfoodeng.2020.110231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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23
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A rare infective cause of stroke in an immunocompetent child. Brain Dev 2021; 43:152-156. [PMID: 32855000 DOI: 10.1016/j.braindev.2020.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/23/2020] [Accepted: 07/26/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Infections are a common cause of childhood stroke with variable presentation. The current case describes a rare infective cause of venous and arterial stroke in an immunocompetent girl with management implications. CASE DESCRIPTION A 12 year old girl, presented with history of fever for 10 days, painful swelling of right eye for 7 days and altered sensorium for 2 days. On examination, she had right eye orbital cellulitis and fullness of right paranasal area. On nervous system examination, she was delirious, had right eye ophthalmoparesis, left upper motor neuron facial palsy and signs of meningeal inflammation. Her contrast enhanced CT head and subsequent MRI brain with arteriography and venography revealed right cavernous sinus and distal internal carotid artery thrombosis. She was started on intravenous ceftriaxone and vancomycin and subcutaneous heparin. In view of persistent symptoms, endoscopic debridement of right nasal cavity was done, which showed growth of aspergillus flavus. Subsequently, she was started on intravenous voriconazole. Within a week, she was afebrile, her inflammatory and neurological signs started improving. She was discharged after 3 weeks of intravenous voriconazole which was continued for 3 more weeks orally. Her procoagulant and immunodeficiency work up were normal. At 4 months follow up, she showed both clinical and radiological resolution. CONCLUSIONS Despite high mortality described in sino-orbital aspergillosis, early and appropriate treatment led to optimal outcome. In deep seated infections, isolation of etiological organism should be attempted, particularly when patient doesn't respond to conventional antimicrobial therapy.
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Umasanker S, Bhakat R, Mehta S, Rathaur VK, Verma PK, Bhat NK, Naithani M, Chacham S. Vitamin B12 deficiency in children from Northern India: Time to reconsider nutritional handicaps. J Family Med Prim Care 2020; 9:4985-4991. [PMID: 33209833 PMCID: PMC7652153 DOI: 10.4103/jfmpc.jfmpc_712_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/11/2020] [Accepted: 06/25/2020] [Indexed: 11/08/2022] Open
Abstract
Background and Aims: Subclinical Vitamin B12 deficiency is a very common entity in the Indian subcontinent with devastating clinical and socio-economic consequences. The objective of this study was to estimate the proportion of vitamin B12 deficient children and to evaluate their clinical profile. Setting and Design: This prospective analytical study was conducted in a tertiary level care institute in Northern India. Materials and Methods: Children with clinical pallor, were included in this study. Detailed history, height, weight percentiles and characteristic features of vitamin B12 deficiency were recorded and complete blood counts, mean corpuscular volume and vitamin B12 levels were done. Statistics: For Qualitative data was analyzed using Pearson Chi square tests and quantitative data was analyzed using two sided independent samples t tests. Results: A total of 111 children were included. 64.8% (n = 72) had vitamin B12 deficiency. Lethargy (63.9%) and weight loss (62.1%), Knuckle pigmentation were common features. One-fourth of the children were on vegetarian diet. Neurological manifestations were significantly associated with fragile hair (p 0.056) and knuckle pigmentation (p 0.027). Younger children had more weight loss (p 0.001), knuckle pigmentation (p 0.019) and hypotonia (p 0.045). One fifth of children presented with neurological manifestations. Conclusions: Two-thirds of the anemic children had vitamin B12 deficiency. There was a bimodal age distribution with regard to B12 deficiency. Neurological manifestations were predominant in younger children [<6] and hematological abnormalities were more frequent in older children [≥6 years]. Estimation of vitamin B12 levels forms an essential component while evaluating children with anemia, despite mixed dietary habits and normal MCV.
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Affiliation(s)
- Swati Umasanker
- Department of Pediatrics, All India Institute of Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rahul Bhakat
- Department of Pediatrics, All India Institute of Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sonalika Mehta
- Department of Pediatrics, All India Institute of Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Vyas Kumar Rathaur
- Department of Pediatrics, All India Institute of Institute of Medical Sciences, Rishikesh, Uttarakhand, India.,Department of Pediatrics, Government Doon Medical College, Dehradun, India, Former Professor, KD Medical College, Mathura, Uttar Pradesh, India
| | - Prashant Kumar Verma
- Department of Pediatrics, All India Institute of Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - N K Bhat
- Department of Pediatrics, All India Institute of Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manisha Naithani
- Department of Biochemistry, All India Institute of Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Swathi Chacham
- Department of Pediatrics, All India Institute of Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Malik E, Rozner L, Adelson M, Schreiber S, Peles E. The Relation between Changes in Vitamin D and Vitamin B12 Levels, Body Mass Index and Outcome in Methadone Maintenance Treatment Patients. J Psychoactive Drugs 2020; 53:55-64. [PMID: 33143561 DOI: 10.1080/02791072.2020.1840680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Patients' Body Mass Index (BMI) increase during methadone maintenance treatment (MMT), and both Vitamins D and B12 deficiencies may be associated with BMI. We studied the relations between BMI, these vitamins and treatment outcome in patients with opioid use disorder receiving MMT. Vitamin B12 levels were available for 272 patients and Vitamin D levels were available for 260 patients. Of those 112 and 80 respectively had two measures (at admission or thereafter, and while stabilized or after one year in treatment). Patients' BMI levels and long-term retention were analyzed. Vitamin B12 was lower in patients abusing cocaine/amphetamine on admission. Vitamin D did not change over time, but a significant weight gain could be observed in 38 patients whose vitamin D was elevated compared to 42 whose levels were not, (25.4 ± 4.8 to 28.8 ± 5.2 vs. 24.3 ± 3.7 to 25.5 ± 4.0, p(Time) < 0.0005, p(Group) = 0.03, p(interaction) = 0.02). BMI changes correlated with vitamin D levels change (r = 0.26, p = .04). Longer cumulative retention was observed among the elevated vitamin D group (8.1 years, 95% CI 6.3-9.8) in comparison with the non-elevated group (4.8y 95% CI 3.6-6.1, Kaplan Meier, p = .02). Stimulants misuse was associated with low B12 levels. Vitamin D elevation is associated with weight gain and longer retention in treatment.
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Affiliation(s)
- Elad Malik
- Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Lihi Rozner
- Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Miriam Adelson
- Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shaul Schreiber
- Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Einat Peles
- Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Kalyan G B, Mittal M, Jain R. Compromised Vitamin B12 Status of Indian Infants and Toddlers. Food Nutr Bull 2020; 41:430-437. [PMID: 32873057 DOI: 10.1177/0379572120950886] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Vitamin B12 deficiency is prevalent worldwide especially in vegetarian communities. Its deficiency in early childhood may result in serious neurological and cognitive deficits. It is important to know the prevalence among our infants and toddlers so that nutritional policy changes could be suggested in this regard. OBJECTIVE To evaluate the vitamin B12 status of apparently healthy Indian children between 6 and 23 months of age. METHODS Apparently healthy Indian children (n = 210), of age 6 to 23 months, attending pediatric outpatient department were recruited and samples obtained to evaluate their hemogram and levels of vitamin B12, folate, and ferritin. Data were analyzed to obtain the mean levels and the proportion of participants deficient in vitamin B12. The dietary habits of the children were also analyzed and correlated with their vitamin B12 status. RESULTS Vitamin B12 deficiency was observed in 37.6% of the participants. CONCLUSIONS There is a high prevalence of vitamin B12 deficiency in our infants and toddlers, and there is need to initiate supplement to prevent any possible neurological consequences. Early initiation of animal milk had a positive effect on the vitamin B12 status of the child, though it was not significant.
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Affiliation(s)
| | - Medha Mittal
- 75299Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Rahul Jain
- 75299Chacha Nehru Bal Chikitsalaya, New Delhi, India
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Bajaj SR, Singhal RS. Degradation kinetics of vitamin B12 in model systems of different pH and extrapolation to carrot and lime juices. J FOOD ENG 2020. [DOI: 10.1016/j.jfoodeng.2019.109800] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bogiatzi C, Azarpazhooh MR, Spence JD. Choosing the right therapy for a patient with asymptomatic carotid stenosis. Expert Rev Cardiovasc Ther 2020; 18:53-63. [PMID: 32043917 DOI: 10.1080/14779072.2020.1729127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: Most patients with asymptomatic carotid stenosis (ACS) now have a lower risk with intensive medical therapy than with stenting (CAS) or endarterectomy (CEA); the annual risk of stroke or death with intensive medical therapy is ~ 0.5%, vs. a periprocedural risk with CAS of ~ 2.5-4.1% with CAS, and ~ 1.4-1.8% with CEA. The excess risk of CAS is greater in older patients.Areas covered: Discussed are the need for intensive medical therapy, the nature of intensive medical therapy, approaches to identifying the few patients with ACS who could benefit from CEA or CAS, and which patients would be better suited to CEA vs. CAS.Expert opinion: All patients with ACS are at high risk of cardiovascular events, soshould receive intensive medical therapy including lifestyle modification, intensive lipid-lowering, B vitamins to lower homocysteine (using methylcobalamin rather than cyanocobalamin), and appropriate antithrombotic therapy. High-risk patients who could benefit from intervention can be identified by clinical and imaging features including transcranial Doppler embolus detection, ulceration, intraplaque hemorrhage, reduced cerebrovascular reserve, plaque echolucency, silent infarction on brain imaging, and progression of stenosis. Most patients whose risk of stroke warrants intervention would be better treated with CEA than with CAS.
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Affiliation(s)
- Chrysi Bogiatzi
- Department of Neurology, McMaster University, Hamilton, Ontario, Canada
| | - M Reza Azarpazhooh
- Department of Clinical Neurological Sciences (Neurology), Western University, London, Ontario, Canada
| | - J David Spence
- Departments of Clinical Neurological Sciences (Neurology) and Internal Medicine (Clinical Pharmacology), Robarts Research Institute, London, Ontario, Canada
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Chakraborty S, Prasad G, Marwaha RK, Basu A, Tandon N, Bharadwaj D. Comparison of plasma adipocytokines & C-reactive protein levels in healthy schoolgoing adolescents from private & government-funded schools of Delhi, India. Indian J Med Res 2020; 151:47-58. [PMID: 32134014 PMCID: PMC7055163 DOI: 10.4103/ijmr.ijmr_1631_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background & objectives Obesity-mediated chronic inflammatory state is primarily governed by lifestyle and food habits in adolescents and marked by alterations in the level of various inflammatory markers. This cross-sectional study was aimed to compare the inflammatory status of healthy Indian adolescents vis-à-vis their obesity profile. The inflammatory state of urban adolescents attending private and government-funded schools, and the relationship between inflammatory marker levels and anthropometric indices in the study participants from both groups were examined. Methods A total of 4438 study participants (10-17 yr) were chosen from various schools of Delhi, India, and their anthropometric parameters were measured. Plasma adipocytokines (adiponectin, leptin and resistin) of the study participants were measured by enzyme-linked immunosorbent assay, and plasma C-reactive protein (CRP) levels were assayed by a biochemical analyzer. Metabolic syndrome-related risk factors such as waist circumference, hip circumference (HC), fasting glucose, fasting insulin, Homeostatic Model Assessment of Insulin Resistance, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol and triglycerides of normal-weight adolescents were also evaluated. Results The level of leptin and CRP increased with increasing adiposity, whereas adiponectin levels were found to be negatively related to obesity. All plasma cytokine levels (adiponectin, leptin and resistin) were significantly elevated in female than male adolescents. Age-based classification revealed a distinct trend of variability in the levels of all the inflammatory markers among adolescents of varying age groups. Significant differences were observed between private and government schoolgoing adolescents in terms of anthropometric and inflammatory parameters, with higher adiposity indices in the former group. The relationship of plasma adipokine and CRP levels with various adiposity indices was found to be distinctly different between private and government schoolgoing students. Interpretation & conclusions Inflammatory markers were significantly elevated in overweight/obese adolescents. The socio-economic condition of urban Indian schoolgoing adolescents reflecting lifestyle transition has profound effects on their adiposity indices and inflammatory states. Longitudinal studies in different regions of the country need to be done to further confirm the findings.
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Affiliation(s)
- Shraddha Chakraborty
- Genomics & Molecular Medicine Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India,Academy of Scientific & Innovative Research, CSIR-Institute of Genomics & Integrative Biology South Campus, New Delhi, India
| | - Gauri Prasad
- Genomics & Molecular Medicine Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India,Academy of Scientific & Innovative Research, CSIR-Institute of Genomics & Integrative Biology South Campus, New Delhi, India
| | - Raman Kumar Marwaha
- Department of Endocrinology, International Life Sciences Institute, New Delhi, India
| | - Analabha Basu
- Statistical & Computational Genomics, National Institute of Biomedical Genomics, Kalyani, West Bengal, India
| | - Nikhil Tandon
- Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Dwaipayan Bharadwaj
- Academy of Scientific & Innovative Research, CSIR-Institute of Genomics & Integrative Biology South Campus, New Delhi, India,Systems Genomics Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi, India,For correspondence: Dr Dwaipayan Bharadwaj, Systems Genomics Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi 110 067, India e-mail:
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Surendran S, Aji AS, Ariyasra U, Sari SR, Malik SG, Tasrif N, Yani FF, Lovegrove JA, Sudji IR, Lipoeto NI, Vimaleswaran KS. A nutrigenetic approach for investigating the relationship between vitamin B12 status and metabolic traits in Indonesian women. J Diabetes Metab Disord 2019; 18:389-399. [PMID: 31890664 PMCID: PMC6914754 DOI: 10.1007/s40200-019-00424-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/09/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE Adverse effects of maternal vitamin B12 deficiency have been linked to major clinical outcomes, including increased body mass index and gestational diabetes, however, less is known about vitamin B12 nutrition in non-pregnant women. Hence, the aim of the present study was to explore the relationships between metabolic traits and vitamin B12 status in a cohort of healthy Indonesian women and to investigate whether these relationships were modified by dietary intake using a genetic approach. METHODS A total of 117 Minangkabau women (aged 25-60 years), from the city of Padang, West Sumatra underwent anthropometric, biochemical, dietary intake analysis and genetic tests. Genetic risk scores (GRS) based on nine vitamin B12 associated single nucleotide polymorphisms (SNPs) (B12-GRS) and nine metabolic SNPs (metabolic-GRS) were constructed. RESULTS The B12-GRS and metabolic-GRS had no effect on vitamin B12 (P > 0.160) and metabolic traits (P > 0.085). However, an interaction was observed between the B12-GRS and dietary fibre intake (g) on glycated haemoglobin (HbA1C) levels (P interaction = 0.042), where among those who consumed a low fibre diet (4.90 ± 1.00 g/day), individuals carrying ≥9 risk alleles for vitamin B12 deficiency had significantly higher HbA1C levels (P = 0.025) compared to those carrying ≤8 risk alleles. CONCLUSION Our study showed a significant impact of the B12-GRS on HbA1C concentrations through the influence of a dietary factor, however, our study failed to provide evidence for an impact of metabolic-GRS on lowering B12 concentrations. Further replication studies utilizing larger sample sizes are needed to confirm our findings.
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Affiliation(s)
- S. Surendran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - A. S. Aji
- Department of Biomedical Science, Faculty of Medicine, Andalas University, Padang, West Sumatra Indonesia
| | - U. Ariyasra
- Department of Biomedical Science, Faculty of Medicine, Andalas University, Padang, West Sumatra Indonesia
| | - S. R. Sari
- Department of Biomedical Science, Faculty of Medicine, Andalas University, Padang, West Sumatra Indonesia
| | - S. G. Malik
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - N. Tasrif
- Public Health Department, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - F. F. Yani
- Department of Child Health, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - J. A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
- Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, UK
| | - I. R. Sudji
- Biomedical Laboratory, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - N. I. Lipoeto
- Department of Nutrition, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
- Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, UK
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Surendran S, Jayashri R, Drysdale L, Bodhini D, Lakshmipriya N, Shanthi Rani CS, Sudha V, Lovegrove JA, Anjana RM, Mohan V, Radha V, Pradeepa R, Vimaleswaran KS. Evidence for the association between FTO gene variants and vitamin B12 concentrations in an Asian Indian population. GENES & NUTRITION 2019; 14:26. [PMID: 31516636 PMCID: PMC6728975 DOI: 10.1186/s12263-019-0649-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/30/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Low vitamin B12 concentrations have been associated with major clinical outcomes, including adiposity, in Indian populations. The Fat mass and obesity-associated gene (FTO) is an established obesity-susceptibility locus; however, it remains unknown whether it influences vitamin B12 status. Hence, we investigated the association of two previously studied FTO polymorphisms with vitamin B12 concentrations and metabolic disease-related outcomes and examined whether these associations were modified by dietary factors and physical activity. METHODS A total of 176 individuals with type 2 diabetes, 152 with pre-diabetes, and 220 normal glucose-tolerant individuals were randomly selected from the Chennai Urban Rural Epidemiology Study. Anthropometric, clinical, and biochemical investigations, which included body mass index (BMI), waist circumference, vitamin B12, homocysteine, and folic acid were measured. A validated food frequency questionnaire was used for dietary assessment and self-reported physical activity measures were collected. An unweighted genetic risk score (GRS) was calculated for two FTO single-nucleotide polymorphisms (rs8050136 and rs2388405) by summation of the number of risk alleles for obesity. Interaction analyses were performed by including the interaction terms in the regression model. RESULTS The GRS was significantly associated with increased BMI (P = 0.009) and risk of obesity (P = 0.023). Individuals carrying more than one risk allele for the GRS had 13.13% lower vitamin B12 concentrations, compared to individuals carrying zero risk alleles (P = 0.018). No associations between the GRS and folic acid and homocysteine concentrations were observed. Furthermore, no statistically significant GRS-diet or GRS-physical activity interactions with vitamin B12, folic acid, homocysteine or metabolic-disease outcomes were observed. CONCLUSION The study shows for the first time that a genetic risk score using two FTO SNPs is associated with lower vitamin B12 concentrations; however, we did not identify any evidence for the influence of lifestyle factors on this association. Further replication studies in larger cohorts are warranted to investigate the association between the GRS and vitamin B12 concentrations.
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Affiliation(s)
- Shelini Surendran
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Whiteknights, PO Box 226, Reading, RG6 6AP UK
| | - Ramamoorthy Jayashri
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai, 600086 India
| | - Lauren Drysdale
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Dhanasekaran Bodhini
- Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai, India
| | - Nagarajan Lakshmipriya
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, India
| | | | - Vasudevan Sudha
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, India
| | - Julie A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Whiteknights, PO Box 226, Reading, RG6 6AP UK
| | - Ranjit M. Anjana
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai, 600086 India
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai, 600086 India
| | - Venkatesan Radha
- Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai, India
| | - Rajendra Pradeepa
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai, 600086 India
| | - Karani S. Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Whiteknights, PO Box 226, Reading, RG6 6AP UK
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Impact of diet management and composition on vitamin B 12 concentration in milk of Holstein cows. Animal 2019; 13:2101-2109. [PMID: 30774051 DOI: 10.1017/s1751731119000211] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
As vitamin B12 is only synthesized by bacteria, ruminant products, especially dairy products, are excellent sources of this vitamin. This study aims to identify if diet and cow characteristics could affect vitamin B12 concentration in milk of dairy cows. Information on 1484 first, 1093 second and 1763 third and greater parity Holstein cows in 100 herds was collected during three consecutive milkings. During the first morning milking, all dietary ingredients given to cows were sampled and quantities offered were recorded throughout the day. Nutrient composition of ingredients was obtained by wet chemistry to reconstitute nutrient composition of the ration. Milk samples were taken with in-line milk meters during the evening milking of the 1st day and the morning milking of the 2nd day and were analyzed for vitamin B12 concentration. Milk yields were recorded and milk components were separately analyzed for each milking. Daily vitamin B12 concentration in milk was obtained using morning and evening vitamin B12 concentrations weighted with respective milk yield, then divided by daily yield. To decrease the number of interdependent variables to include in the multivariable model, a principal component analysis was carried out. Daily milk concentration of vitamin B12 averaged 3809±80 pg/ml, 4178±79 pg/ml and 4399±77 pg/ml for first, second and third, and greater lactation cows. Out of 11 principal components, six were significantly related to daily milk concentration of vitamin B12 when entered in the multivariable model. Results suggested that vitamin B12 concentration in milk was positively related to percentage of fiber and negatively related to starch as well as energy of the diet. Negative relationships were noted between vitamin B12 concentration in milk and milk yield as well as milk lactose concentration and positive relationships were observed between vitamin B12 concentration in milk and milk fat as well as protein concentrations. The percentages of chopped mixed silage and commercial energy supplement in the diet as well as cow BW were positively related to vitamin B12 in milk and percentages of baled mixed silage, corn and commercial protein supplement in the ration were negatively related to vitamin B12 concentration in milk. The pseudo-R2 of the model was low (52%) suggesting that diet and cow characteristics have moderate impact on vitamin B12 concentration in milk. Moreover, when entering solely the principal component related to milk production in the model, the pseudo-R2 was 46%. In conclusion, it suggests that studied diet characteristics have a marginal impact on vitamin B12 concentration in milk variation.
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Ahmed S, Bogiatzi C, Hackam DG, Rutledge AC, Sposato LA, Khaw A, Mandzia J, Azarpazhoo MR, Hachinski V, Spence JD. Vitamin B 12 deficiency and hyperhomocysteinaemia in outpatients with stroke or transient ischaemic attack: a cohort study at an academic medical centre. BMJ Open 2019; 9:e026564. [PMID: 30670531 PMCID: PMC6347886 DOI: 10.1136/bmjopen-2018-026564] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/02/2018] [Accepted: 12/05/2018] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE We sought to assess the current magnitude of the opportunity for secondary stroke prevention with B vitamins. DESIGN A cohort study. SETTING The Urgent TIA (Transient Ischaemic Attack) Clinic at an academic medical centre. MAIN OUTCOME MEASURES We assessed the prevalence of biochemical vitamin B12 deficiency (B12Def, serum B12 <156 pmol/L), hyperhomocysteinaemia (HHcy; plasma total homocysteine [tHcy] >14 µmol/L) and metabolic B12 deficiency (MetB12Def, serum B12 <258 pmol/L and HHcy) between 2002 and 2017, by age group and by stroke subtype. RESULTS Data were available in 4055 patients. B12Def was present in 8.2% of patients overall; it declined from 10.9% of patients referred before 2009 to 5.4% thereafter (p=0.0001). MetB12Def was present in 10.6% of patients, and HHcy was present in 19.1% of patients. Among the patients aged ≥80 years, MetB12Def was present in 18.1% and HHcy in 35%. Among the 3410 patients whose stroke subtype was determined, HHcy was present in 18.4% of patients: 23.3% of large artery atherosclerosis, 18.1% of cardioembolic, 16.3% of small vessel disease, 10.8% of other unusual aetiologies and 13.6% of undetermined subtypes (p=0.0001). CONCLUSIONS Despite a decline in our referral area since 2009, B12Def, MetB12Def and HHcy remain common in patients with stroke/TIA. Because these conditions are easily treated and have serious consequences, all patients with stroke/TIA should have their serum B12 and tHcy measured.
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Affiliation(s)
- Shamon Ahmed
- University of British Columbia Medical School, Vancouver, British Columbia, Canada
| | | | - Daniel G Hackam
- Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- University Hospital, London, Ontario, Canada
| | - Angela C Rutledge
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
- Victoria Hospital, London, Ontario, Canada
| | - Luciano A Sposato
- University Hospital, London, Ontario, Canada
- Division of Neurology, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
- Dementia and Heart Disease Lab, Western University, London, Ontario, Canada
| | - Alexander Khaw
- University Hospital, London, Ontario, Canada
- Division of Neurology, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Jennifer Mandzia
- University Hospital, London, Ontario, Canada
- Division of Neurology, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Mahmoud Reza Azarpazhoo
- University Hospital, London, Ontario, Canada
- Division of Neurology, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Vladimir Hachinski
- University Hospital, London, Ontario, Canada
- Division of Neurology, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - J David Spence
- Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- University Hospital, London, Ontario, Canada
- Division of Neurology, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
- Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada
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Abstract
Micronutrients play an important role in the proper growth and development of the human body and its deficiency affects the health contributing to low productivity and vicious cycle of malnutrition, underdevelopment as well as poverty. Micronutrient deficiency is a public health problem affecting more than one-fourth of the global population. Several programmes have been launched over the years in India to improve nutrition and health status of the population; however, a large portion of the population is still affected by micronutrient deficiency. Anaemia, the most common form of micronutrient deficiency affects almost 50 to 60 per cent preschool children and women, while vitamin A deficiency and iodine-deficiency disorders (IDD) have improved over the years. This review focuses on the current scenario of micronutrient (anaemia, vitamin A, iodine, vitamin B12, folate, ferritin, zinc, copper and vitamin C) status in the country covering national surveys as well as recent studies carried out.
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Affiliation(s)
- Zaozianlungliu Gonmei
- Centre for Promotion of Nutrition Research and Training with Special Focus on North East, Tribal & Inaccessible Population, Division of Nutrition, Indian Council of Medical Research (Campus II), Tuberculosis Association of India Building, New Delhi, India
| | - G.S. Toteja
- Centre for Promotion of Nutrition Research and Training with Special Focus on North East, Tribal & Inaccessible Population, Division of Nutrition, Indian Council of Medical Research (Campus II), Tuberculosis Association of India Building, New Delhi, India
- ICMR-Desert Medicine Research Centre, Jodhpur, India
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